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KEY POINTS
Depression is a common and chronic disease that can cause serious harm to patients and increases the risk of death.
Treatment goals for depression include reduction or remission of current symptoms, return to a full level of functioning, and prevention of future depressive episodes and/or relapse.
Medications commonly used to treat depression include selective serotonin reuptake inhibitors (eg, sertraline), serotonin-norepinephrine reuptake inhibitors (eg, venlafaxine), bupropion, and tricyclic antidepressants (eg, amitriptyline).
MTM providers should educate patients and/or their support system (eg, family members) about the delay in onset of antidepressant effects.
Medication therapy management (MTM) providers should explain the importance of adherence throughout the entire course of antidepressant treatment.
MTM providers should advise care when patients are switching between antidepressants to avoid withdrawal symptoms and ensure a consistent therapeutic response.
Patients with depression should be assessed for suicide risk, and MTM providers should be familiar with supportive resources for patients expressing suicidal ideation (eg, National Suicide Prevention Lifeline 1-800-273-8255).
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INTRODUCTION TO MAJOR DEPRESSIVE DISORDER
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Recognizing Depression
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Major depressive disorder (MDD) is characterized by discrete episodes of at least 2 weeks’ duration (although most episodes last considerably longer) involving clear-cut changes in affect, cognition, and neurovegetative functions, and interepisode remissions.1 According to criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, a major depressive episode is defined by the criteria listed in Table 20-1.1
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